This proposal embodies several clinical research projects involving patients who have bladder carcinoma. These projects are to be conducted in several institutions simultaneously and the data will be correlated in one statistical center. In each center, surveillance of all patients admitted with bladder carcinoma will be conducted. Multiple mucosal biopsies will be obtained from patients with flank tumor and/or positive cytology and in these patients evaluation of urinary cytological examination will also be conducted. The ablative and prophylactic effects of N, N', N"-Triethylenethiophosphoramide (THIOTEPA) will be determined and a comparison of the effectiveness of definitive radiotherapy and preoperative radiotherapy followed by appropriate open surgery will be made relative not only to survival alone but to the quality of survival as well.